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Thursday, May 19, 2011

[AlternativeAnswers] Peds Ehrlichiosis


_Re: Ehrlichiosis_

Pediatr Blood Cancer. 2010 May;54(5):776-8.

Severe ehrlichia infection in pediatric oncology and stem cell transplant

Esbenshade A, Esbenshade J, Domm J, Williams J, Frangoul H.

Department of Pediatrics, Vanderbilt University School of Medicine,
Nashville, TN, USA. _adam.esbenshade@vanderbilt.edu_

Ehrlichiosis, a tickborne illness transmitted by tick vectors Amblyomma
americanum and Ixodes scapularis, can be acquired in endemic areas. Clinical
manifestations range from asymptomatic to fulminant in nature. We report
three cases of ehrlichiosis in pediatric oncology patients, one of whom was a
stem cell transplant recipient. Early symptoms included fever, malaise,
and vague gastrointestinal symptoms. Laboratory abnormalities were initially
attributed to chemotherapy toxicity. Illness was severe in all three
patients and one patient died even after initiation of doxycycline. These cases
emphasize the need for a high index of suspicion for tickborne illness in
oncology patients, and the importance of a low threshold for starting empiric
treatment before confirming the diagnosis.

PMID: 20052776

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